Minimally invasive surgery provides some significant advantages over open surgical procedures and as such, is being more frequently utilized. However, minimally invasive surgery and surgical techniques, for example, minimal incision surgery such as is utilized in spinal procedures, have created a special set of requirements with regard to the visualization of the operative field. These special requirements or changed parameters include the operative field being significantly reduced in size as compared to open surgical procedures. However, the depth parameter for the surgical procedure has remained unchanged. Therefore, the incision size to incision depth ratio has been markedly decreased very often geometrically creating unique challenges for the surgeon.
For example, unique geometry of the reduced size of the incision places severe constraints on the space available for the placement of surgical instruments in the area where the procedure is being performed. Visualization of the surgical area is also severely limited due to among other things, the size of the incision. As such, the size and number of surgical instruments that may be simultaneously used during minimally invasive surgical procedures is quite limited.
Additionally, minimally invasive surgical techniques typically require suction to be placed or located almost directly adjacent to the operative site. The proximity of the suction and visualization devices creates additional challenges relating to: design and material choice, and cost of manufacture/purchase. For example, especially when performing procedures with relatively small space constraints such as for example minimally invasive surgery, frequently requires the surgeon to utilize relatively high-speed abrasive rotating instruments. With relatively tight space constraints, this type of cutting tool may frequently come into contact with other surgical devices positioned within the surgical area. It is not uncommon for the other surgical devices to become damaged by this incidental contact. This can become quite costly for the hospital/surgeon to have to regularly repair and/or replace expensive surgical equipment in this manner.
Another problem with know illumination systems is the generation of heat at the light exit location due to the relatively large amount of optical energy exiting the device. Excessive heat in a surgical area should be avoided as it can lead to congealing of blood and in certain cases, burning of the surrounding tissue.
A number of previous systems have attempted to address a few of these problems with limited success. For example, U.S. Pat. No. 5,588,952 (“Dandolu”) discloses a combination illumination and aspiration device. Dandolu further discloses that “reflector” is positioned at the tip of the device to diffuse and focus the emitted light from the side wall of the device. However, Dandolu fails to teach or suggest a system that projects illuminating light ahead of the suction tip. Rather, Dandolu discloses that a fiber optic cable emits light out of a side portion of the device, perpendicular to the longitudinal axis of the suction device. Additionally, Dandolu concentrates the optical exit point of the illuminating light thereby generating excessive heat, which is highly undesirable.
U.S. Pat. No. 4,872,837 (“Issalene et al.”) discloses an instrument capable of both illumination and aspiration. Issalene et al. further teaches use of a cannula having a beveled front end that may be used to concentrate and/or direct illuminating light in a controlled manner. However, Issalene et al. fails to teach or suggest a system that includes a plurality of optical fibers surrounding an aspiration tube to maximize the light projected ahead of the suction tip or that the optical fibers terminate a distance from the tip such that in the event of damage to the tip, the optical fibers are not damaged. Additionally, Issalene et al. provides a single optical point of illumination that will generate excessive heat.
U.S. Pat. No. 5,213,092 (“Uram”) discloses a combination aspiration and illumination/image guiding system. However, Uram positions the illuminating/image guides and aspiration tube side-by-side, which disadvantageously increases the overall size of the device. With minimally invasive surgical procedures, it is critical that the device remain a small in diameter as reasonably possible. Accordingly, Uram fails to teach a combination suction and illumination device that presents one concentric system to provide the smallest diameter possible. In addition, as the illumination guide is offset from the suction tube, such that illumination of the area ahead of the device will suffer.
Therefore, what is desired is a surgical system and method that provides for increased visualization in the surgical area while at the same time not further restricting the working area for the surgeon.
It is further desired to provide a surgical system and method that may effectively be utilized in connection with minimally invasive surgery that provides for increased visualization of the area where the surgical procedure is to be performed.
It is still further desired to provide a surgical system and method that minimizes the number of surgical tools that must be simultaneously inserted into the incision.
It is yet further desired to provide a surgical system and method that reduces the costs of suction and visualization tools.
It is also desired to provide a surgical system that allows the user to position the device in various angles and locations despite having limited access to the area as is the case in non-invasive surgical procedures.
It is further desired to provide a surgical system and method that provides illuminating light to a surgical area while minimizing any amount of heat that may be generated by the illuminating light.